{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:24:07Z","timestamp":1777577047070,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,7,30]],"date-time":"2015-07-30T00:00:00Z","timestamp":1438214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The role of esophagogastric junction contractile integral (<jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) as assessed by high\u2010resolution manometry (<jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content>) is unclear. We aimed to correlate the <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> with impedance\u2010pH findings in gastro\u2010esophageal reflux disease (<jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> symptoms were enrolled. All patients underwent upper endoscopy, <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content>, and impedance\u2010pH testing. The <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> was calculated using the distal contractile integral tool box during three consecutive respiratory cycles. The value was then divided by the duration of these cycles. A value below 13 was considered as a defective <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>. We also assessed <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> morphology, esophageal acid exposure time (<jats:styled-content style=\"fixed-case\">AET<\/jats:styled-content>), number of reflux episodes (<jats:styled-content style=\"fixed-case\">NRE<\/jats:styled-content>), and symptom association analysis (<jats:styled-content style=\"fixed-case\">SAA<\/jats:styled-content>). A positive impedance\u2010pH monitoring was considered in case of abnormal <jats:styled-content style=\"fixed-case\">AET<\/jats:styled-content> and\/or <jats:styled-content style=\"fixed-case\">NRE<\/jats:styled-content> and\/or positive <jats:styled-content style=\"fixed-case\">SAA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Among 130 patients we enrolled, 91 had <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> (abnormal <jats:styled-content style=\"fixed-case\">AET<\/jats:styled-content> and\/or elevated <jats:styled-content style=\"fixed-case\">NRE<\/jats:styled-content> and\/or positive <jats:styled-content style=\"fixed-case\">SAA<\/jats:styled-content>) and 39 had functional heartburn (<jats:styled-content style=\"fixed-case\">FH<\/jats:styled-content>) (negative endoscopy, normal <jats:styled-content style=\"fixed-case\">AET<\/jats:styled-content>, normal <jats:styled-content style=\"fixed-case\">NRE<\/jats:styled-content>, and negative <jats:styled-content style=\"fixed-case\">SAA<\/jats:styled-content>). The <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> patients had a lower median value of <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> (11 [3.1\u201320.7] <jats:italic>vs<\/jats:italic> 22 [9.9\u201341], <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.02) compared to <jats:styled-content style=\"fixed-case\">FH<\/jats:styled-content> patients. Patients with a defective <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> had, more frequently, a positive impedance\u2010pH monitoring or esophageal mucosal lesions at endoscopy (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05 and <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05, respectively) than patients with a normal <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>. An <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> cut\u2010off value of 5\u00a0mmHg\u00a0cm yielded the optimal performance in identifying <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> at impedance\u2010pH (sensitivity 89%\u2013specificity 63%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>A defective <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> at <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> is clearly associated with evidence of <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> at impedance\u2010pH monitoring. Evaluating <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> may be useful to predict an abnormal impedance\u2010pH testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12638","type":"journal-article","created":{"date-parts":[[2015,7,31]],"date-time":"2015-07-31T03:27:40Z","timestamp":1438313260000},"page":"1423-1431","source":"Crossref","is-referenced-by-count":98,"title":["Esophagogastric junction contractility for clinical assessment in patients with <scp>GERD<\/scp>: a real added value?"],"prefix":"10.1111","volume":"27","author":[{"given":"S.","family":"Tolone","sequence":"first","affiliation":[{"name":"Division of Surgery Department of Surgery Second University of Naples Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"De Bortoli","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Internal Medicine University 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